Having a health card brings convenience when it comes to medical expenses. If you have an HMO account or is looking for one, it is best to know what services are covered.
Lab Tests
Basic routine lab tests are covered. You may go to the company’s free standing clinics or any accredited hospitals provided that you have doctor prescription.
- Complete blood count
- FBS
- RBS
- Cholesterol Lipid Profile
- Triglycerides
- SGPT
- SGOT
- Uric acid
- Fecalysis
- Urinalysis
Diagnostic Tests
Imaging test is one of the most common covered diagnostics by most HMOs. Depending on the benefits and features, specific procedures are covered. An accredited doctor’s prescription is therefore required.
- CT Scan (Various body parts)
- MRI Scan (Various body parts)
- X-Ray
- Ultrasound
- ECG
- ESL Shockwave
- 2D echo
- EEG
- ECG
Medical Procedures
Animal bite treatment
Surgery (suturing)
Wound treatment (injuries)
Medicines and Supplies
In terms of ER coverage, immediate relief medicines are covered. However, in-patient coverage may differ based on your plan. Some of the covered expenses include but not limited to:
- Medicines
- IV fluids
- Oxygen
Emergency Room
Many of the health cards available in the Philippines cover the ER procedures. This will include the following benefits:
- Room fee
- Medical devices and equipment
- Doctor’s fee
- Imaging tests
- Emergency treatment
Prepaid ER card is valid for 1 year from activation date The price of coverage for ER range from Php 25,000 to Php 50,000 for prepaid health cards.
Doctor Consultation
Check up fees are covered by HMO even by prepaid cards. As long as the doctor is accredited by the company, the patient gets consultation fee coverage. Some special prepaid cards can be used for unlimited consultations for one year.
Room and Board
Hospitals rooms are covered by most comprehensive HMO plans. The room type varies depending on the account holder’s policy. One may avail of ward, semi private, regular room or suite.
Dental Services
Dental coverage is usually indicated at the start of the policy as an add on. If you have an individual plan, you may opt to get dental coverage. Regular filling and cleaning (oral prophylaxis) are covered by most dental benefits.
Maximum Limit
How much is the maximum limit of HMO? Many health cards offer up to Php 250,000 MBL or maximum benefit limit. When the patient consumes all of the amount, no coverage will be applied until the next renewal.
Health Plans Vs Prepaid
Most HMOs offer either a health package plan or a prepaid plan depending on client preferences. Usually, regular employees avail of the health plans as part of their employers’ offers. On the other hand, self employed, freelancers and senior citizens usually avail the prepaid HMO cards.
Last Updated on April 26, 2024 by Medical Pinas
About the Author: MedicalPinas has several years of experience in publishing articles to help Filipinos find medical services and their prices. It strives to provide the most accurate info available through extensive research. Info may change without notice. This site is not affiliated with any of the mentioned brands/companies and does not represent the same.